Please be sure to complete every entry below, if you have a question or concern please inform the instructor.
(Students who do not complete roster will not receive credit for class)
For example 305-555-5555
What do you do for a living?
Where did you hear about us?
(Google, Yahoo, Friend, Facebook, Instagram, etc)
Enter birthday MM / DD / YYYY
Enter how you purchased our course
Enter Groupon Voucher If Applicable
Enter Voucher number if applicable
I am over 21+
I am under 21